Quality Management

Proven quality assurance services.

Quality Management

Proven quality assurance services

Quality Management

Health plans are moving with an increasing sense of urgency toward adopting alternative payment models based on pay-for-performance metrics. That means more payors and providers are focused on meeting quality measures. The scores payors receive on quality measures enable consumers to compare and contrast which health plans will meet their needs.

To help payors meet their quality and performance goals, MedReview offers:

  • In-house and on-site HEDIS/QARR data collection, abstraction, clinical review and overread services.
  • URAC-accredited independent review organization (IRO) providing timely and objective expert medical reviews.
  • Assessment and authorization of Personal Care Services on behalf of Medicaid Managed Care providers.

MedReview’s quality management program helps payors increase operational efficiencies, mitigate clinical and professional risks and assure compliance in accordance with industry requirements and regulations. With more than four decades of experience serving as an independent auditor of healthcare claims throughout the U.S., we continue to set the standard for accuracy and professionalism in quality assurance.

Our Quality Management services:

HEDIS/QARR Reviews

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Independent Review

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Medicaid Managed Care Assessments

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